The Australian Government Wants To Make Life-Saving Pap Smears Cost More

The federal government late last year proposed changes that would see bulk-billing cut for pathology and MRI services from 1 July 2016, including potentially life-saving pap smears. In response, a petition to federal health minister Susan Ley has already collected almost 150,000 signatures in only two days.

"To Health Minister Sussan Ley,
We demand pap smears and pathology services remain free of charge.
It is disgusting that your government is cutting bulk billing incentives for pap smears, MRI's, urine/blood tests, X-rays and ultrasounds. According to the Royal College of Pathologists of Australasia president Michael Harrison, the cuts will force patients to pay at least $30 for a pap smear, urine or blood test. The Australian Diagnostic Imaging Association claims people could pay up to $173 for an MRI scan.
These cuts are unfair to the average Australian, but will especially hurt women. Free and accessible pathology tests are key to ensuring early detection of cervical cancer, STI's, UTI's and pregnancy. Late detection will lead to MORE cost to the taxpayer in the long run. These essential services are a backbone of our world class healthcare system."

While Ms Ley admits "some may be worse off", overall she doesn't expect this to be the norm, because "what we will see is further competition" within the pathology business driving prices down.

Mr Harrison disputes this, stating that it is "very unlikely" laboratories will be able to absorb the costs. He says patients can expect to pay a minimum $30 for pap smears, or urine and blood tests.

A spokesperson for Ms Ley has responded to these figures, stating “Alleged claims by pathologists about the potential cost of raising their prices as a result of any changes are misleading, because they have omitted the value of the Medicare rebate a patient receives from the Government to help cover this very cost.”

“There are no changes proposed in MYEFO [Mid-Year Economic and Fiscal Outlook] regarding the cost of either receiving or delivering a physical Pap smear examination undertaken by your GP or specialist, nor their billing practices.”
Under the proposed changes patients will have to pay for an X-ray ($101), ultrasound ($206) or MRI ($532) upfront. After rebate, would be left with the gap to cover. That's $6-$56 for X-rays, $12-$101 for ultrasounds and $62-$173 for MRI's according to The Australian Diagnostic Imaging Association.

"If you have a serious condition - cancer, a heart disorder, arthritis, vascular issues - then you will need diagnostic imaging again and again to evaluate the condition and properly monitor treatment," association president Christian Wriedt said.

"So often it will be the sickest people who will be hit the hardest."

Commenters on the petition are sharing their stories of why accessible, free testing is important to them.

One woman states "A free pap smear detected type III carcinogenic cells. I was at university at the time and wouldn't have had the money to pay for a pap smear. It saved my life — now I am a professional contributing to my society."

"I'm 24 and have an autoimmune disease which needs to be carefully monitored, as well as taking medication that suppresses my immune system and makes me more vulnerable to serious infections. Free and regular blood tests are important for my health and peace of mind, and as a woman so are pap smears. If I pay my taxes, I would like to think they go towards supporting these critical services for everyone else - not ex-PMs pensions or the wages of Transfield. Health is so important, these small but critical services should not be sacrificed," writes another.

The office of Susan Ley has been contacted for comment regarding the petition.

This is a bit tough to swallow.
So at the moment I suspect I have a fracture in my ankle. I would have to pay $80 for GP visit, they would then send me for a x-Ray $101 and then back to the GP for a follow up, another $80.

Even with the rebates, you're still looking at around $100 out of pocket.

I work full time, earn a decent wage, but this would just make me less inclined to get it checked out. Even worse is for the preventative exams like pap smears and forms of prostate exams that use blood tests. People hate going to begin with let along being charged more.

Given the times I've had a fracture and there's nothing they can do about it unless it doesn't get better, I only go if I know it's rooted. Especially after tearing the dorsal ligaments off one arm, having three xrays, an MRI and a CT scan, for them to tell me to take it easy forprettymuchever.

This is bad and I don't support the government's move at all, but... all of the coverage I have seen of this has been about pap-smears costing more. That sucks but it doesn't accurately reflect the scope of the changes.

When I first heard the reports I glossed over it because as a man I didn't know the existing cost of pap-smears and it's not something that I really thought about.

You say that the government wants to increase the cost of all pathology and imaging services and suddenly I'm a lot more attentive. People have blood tests all the time. People have X-Rays all the time.

I don't want to come across the wrong way but it seems that the media is only focusing on one aspect of this change. Shouldn't the headline be The Australian Government Wants To Make Life-Saving Diagnostic Tests Cost More. Blood tests save lives too. MRIs save lives too. Ultrasounds save lives too.

How is increasing the cost of diagnostic tests, which will probably cause more people to wait longer before they seek treatment and therefore cost more to address, going to save money? Are they hoping people die sooner and so will end up costing less?

Quite a few changes have come in relating to diagnostic procedure charges. Some changes are fair (some diagnostic procedures are outdated and rarely used and thus don't need cover) but thugs like this are outrageous.

It does seem slightly disingenuous to focus predominately on Pap smears given the utility of MRI and X-Ray, which benefits everyone across a massive list of potential diagnoses.

I do agree, but I think it's more to do with women having to get regular pap-smears no matter the cost, hence the petition to make them exempt from the changes. I think if I was a woman I would be pissed, as a man I'm not really fussed by the changes.

Yeah, its absolutely disgusting!!!
To make sure we get maximum exposure to this outrages money grab, let’s make it all about the population with a vagina…hell they should never and I repeat never, have to pay for anything

No. They are NOT cutting the bulk billing. They are cutting the extra $2-3 INCENTIVE payment to the private companies (introduced by labor a couple years ago) that was intended to encourage them to increase bulk bill more. You will still be bulk billed (unless the private providers choose to charge, which they can at anytime yesterday, today or tomorrow) . sometimes whether they charge or not is determined by the GP and what boxes they tick on the referral.

Please stop falling for the union and private company shareholder propaganda.

Of course. The government can even abolish paying doctors. Why do doctors need to be payed? There are doctors in a lot of countries who do charity work and they can start here too. The government doesn't mandate doctors have to charge.

See my above comment about the likelihood of a private company absorbing a new cost/loss of payment and accepting the fact that they have to make less profit from now on, as opposed to passing the cost on to customers to ensure they don't make less money this year than they did last year.

OMG Gizmodo seems to have been hijacked by extreme lefties in the editorial team. This is another example. Are you guys stooges for The Guardian newspaper now? How about focusing on your core competency of TECH-RELATED reporting, rather than ill-informed, lefty-biased, political blogging?

The changes to Medicare rebates are designed to reduce unnecessary referral to pathologists which drain government coffers (ie., our taxes). This is a reasonable move to minimize profiteering by pathology businesses. You can bet your house that it's the pathology industry trying to mobilize public opinion against this move, because it attacks their lazy revenue model.

Get over it. This is factual reporting. You just dont like it because it harms those stooges known as the LNP. Would be chucking the same sooky la la if the article was heavily right wing bias? Or is it only bad when its against the LNP?

Doctors send patients for an x-ray and/or CT for reasons that he believes are utterly pointless. He reckons at least 70% of his time in a day is spent doing scans which show absolutely nothing. Healthy, normal, perfectly functional. And his clinic then picks up a medicare payment for bulk-billing that scan. Money the taxpayer didn't have to spend.

Thing is... neither he nor our GP mate know of any marketing reps or agents running around like pharma reps in the US, convincing doctors to send patients to get scans that are probably going to show a relatively healthy body. They're doing it because they want to rule out hypothetical conditions, narrowing down their diagnosis with greater accuracy

It would seem that as far as Australia's GPs are concerned, having more information than you need is better than not having enough. And maybe for the good of the health system and medicare spending, that needs to be addressed so that 'just in case' is weaned down to, 'where there's a reasonable suspicion'?

***But regardless of how you handle it... this measure isn't about curbing 'unnecessary diagnostics'. You've completely diverted the subject. This is about finding money for the budget from places they think people won't notice.
****

But let me explain what this is actually about:

Clinics don't have to bulk bill - they can charge whatever the hell they want to ensure they pay their staff whatever suits them and earn whatever profit makes their partners or investors happy. And for some of them, the medicare rebate isn't enough to make the kind of profits they want to.

Obviously that's not great for Australians who want to seek health care, especially if they can't afford the up-front cost, even if they get their rebate afterwards.
Eg: My GP costs me $75 up-front, and I get what... $30-35 back? In effect, it has cost me $40. To be seen that day, at any rate, rather than a week later at a bulk-bill clinic that's overbooked indefinitely, and in the middle of nowhere, costing me an entire day in travel time and waiting in the waiting room for hours past my appointment. But there was a time when I was struggling, that I could've have even afforded the $40 out of pocket, let alone the $75 up-front.

So. We WANT clinics to bulk-bill, so that patients actually get the tests they need so they can actually get treated instead of letting things snowball. And we DON'T want to have everyone going to the Emergency room where they're forced to bulk bill, like what happens in the US, because ERs are clogged enough as it is.

So we pay incentives to clinics to convince them to bulk-bill, for the good of the public, instead of charging what they want to for profit.

Now, if you chop that out and genuinely believe that the clinics are going to accept that they no longer have an incentive to earn less money but they'll just keep doing it out of the kindness of their hearts and their social conscience, then I have a bridge to sell you.

I work in pathology, businesses have been absorbing costs for years. Mainly due to a highly effective government playing one against another. No problem there. Also some tests have become rorts - fine - abolish them. These cuts are way beyond anything that can be absorbed, especially as EVERY year the pathology funding is decreased relative to cost of testing. I predict the system will become user pays (favourite Howard phrase) at the cost of health. To put it simply a test to detect now prevents exorbitant prolonged treatment later. NO it's not pathology businesses mobilizing public opinion - they cannot find their asses with a map.

Now now, they need to pay for those over sized houses and mansions not to mention their holiday homes and expensive cars. Lets just drop their wage by around 50-60%, that will do nicely to free some money, might even change the way they think.

Good. Its about time that the socialist utopia of free healthcare was brought into the real world with a truly egalitarian user pays system. I would prefer my tax dollars went to something that truly keeps us all safe, like submarines.

In one article - I read the pap smear is being deprecated for a HPV test in 2017, *(although I believe it's still effectively the same procedure). But that this is another reason for this being "adjusted" in these changes.

What a load of cobblers that this will impact women more than men. I can tell you that all men require prostate checks (PSA blood test), yet that seems to have been missed. I have to have one annually, and I can only expect that frequency to increase. Ignoring this male specific test, the simple fact that men on average die younger than women, should be sending a danger signal to all men in the community - get an annual check up which includes blood tests, starting early, not in your 40's or 50's..

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